T-cell-rich HLA-haploidentical hematopoietic stem cell transplantation for relapsed/refractory pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia without posttransplant tyrosine kinase inhibitor therapy

Pediatr Blood Cancer. 2017 Mar;64(3). doi: 10.1002/pbc.26242. Epub 2016 Oct 26.

Abstract

Intensive chemotherapy with tyrosine kinase inhibitor (TKI) improves the prognosis of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-ALL). However, the prognosis of cases of relapsed or refractory Ph-ALL remains poor. Here, we aimed to assess the efficacy of T-cell-rich HLA-haploidentical hematopoietic stem cell transplantation (TCR-haplo-HSCT) in eight patients with relapsed or refractory pediatric Ph-ALL. Transplant-related mortality was observed in two patients. All patients discontinued TKI after receiving TCR-haplo-HSCT. The 3-year probability of overall survival and event-free survival was 75.0 and 62.5%, respectively. These results indicate the efficacy of TCR-haplo-HSCT for relapsed/refractory pediatric Ph-ALL.

Keywords: Philadelphia chromosome; acute lymphoblastic leukemia; children; haploidentical hematopoietic stem cell transplantation; relapse; tyrosine kinase inhibitor.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Drug Resistance, Neoplasm*
  • Female
  • Follow-Up Studies
  • HLA Antigens / immunology*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Infant
  • Male
  • Neoplasm Recurrence, Local / immunology
  • Neoplasm Recurrence, Local / therapy*
  • Philadelphia Chromosome*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / immunology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Prognosis
  • Protein Kinase Inhibitors / therapeutic use
  • Protein-Tyrosine Kinases / antagonists & inhibitors
  • Retrospective Studies
  • Salvage Therapy
  • T-Lymphocytes / immunology*
  • Transplantation Conditioning
  • Transplantation, Homologous

Substances

  • HLA Antigens
  • Protein Kinase Inhibitors
  • Protein-Tyrosine Kinases